| NPI | 1922240324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONDRA WHITEMON Owner 817-800-6911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |